The easiest way to pay for nursing home care for the elderly or disabled family members is also the hardest. You write a monthly check. It hurts because the current average annual cost is $70,128.

It makes sense to talk to a knowledgeable lawyer or accountant before writing a check so that your family will not ignore tax breaks or available benefits. For example, if you pay more than 50% support for relatives who meet certain total income criteria, you can apply for relatives as a dependency on your own federal tax return. You may also be eligible for dependent credits for dependent parents who require full-time attention.

I.R.S. also allows for tax cuts for qualified long-term care services. As long as it is established by licensed medical practitioners, many of the costs of nursing homes can be reduced by medical expenses under appropriate plans.

Medical expenses can be deducted item by item as long as they exceed 7.5% of the adjusted total income. Qualified health insurance premiums, long-term care services and other eligible medical expenses can be added together to meet this deadline. If you pay for a nursing home for a parent or a disabled family member, you must consider this deduction.

Many people turned to Medicaid to write checks for nursing home care. The program is co-financed by the states and the US government. The first obstacle is that your family must have medical reasons to go to a nursing home. This is not a housing plan. The next obstacle is income and asset guidelines. The Medicaid Single Guide guides assets to the bank for $2,000, possibly for cars, some personal property and prepaid funeral accounts. The rules are more generous to the spouse. Spouses can retain approximately $100,000 in assets and homes. If any assets are issued within five years prior to the application, these transfers may prevent your family members from qualifying. The guidelines for each state vary.

Considering that some government statistics predict that 50% of the US population will spend at least some time in nursing homes, it is a good idea to consider long-term care insurance. Our average stay is 11 months. Long-term care insurance policies have many different characteristics, including daily benefits, elimination periods, inflation passengers and length limits. Two good starting points are to make sure that any policies you purchase are eligible for taxation and that the insurance company is sound. Since long-term care insurance is a new product and the company's claim losses are limited, the price is reasonable.

The US Veterans Administration is another possible source of nursing home care. The US Veterans Administration maintains approximately 115 nursing facilities. This is a very small number to accommodate all of our veterans. They each have about 300 beds, some veteran spouses, surviving spouses and certain eligible parents, such as the Venus mother.

Medicare is another checkbook, but its funding is very limited. This will not happen until the patient has spent three days in the hospital and the doctor has prescribed “skilled care” to the nursing home. After 21 days, you must pay a major co-payment check of $128 per day. The intermediary gap policy can cover this, but your own checkbook will pay the full salary again after 100 days.

Advance planning and consultation is worthwhile, and in the long run, long-term care insurance may be cheap.

Joseph M. Hoffmann, Esq. A Newton lawyer who helps clients with trusts, estate planning, wills and related transactions.

Method of paying for nursing home nursing expenses was originally published on Spring